British Journal of Renal Medicine - 2001

Comment: Who framed renal services?
John Bradley
pp 4-4
National Service Frameworks (NSFs) were first introduced in 1998 with the aim of setting out what patients can expect to receive from the NHS in major care areas or disease groups. NSF was introduced as a new acronym to the new NHS. Progress would be monitored by the Commission for Health Improvement, initially known affectionately as CHImp, but later abbreviated further to CHI to show this was a significant development, not monkey business. Immediate progress was achieved by developing work already under way on children's intensive care and Calman–Hine cancer services into National Service Frameworks in these areas.
Non-dialytic management of acute renal failure in the ICU
Geoffrey Bihl
pp 6-8
Acute renal failure (ARF) is one of the causes of acute organ failure in which complete recovery is possible, provided that the patient survives the associated comorbid conditions. The most serious forms of ARF are found in the intensive care unit (ICU), where up to 25% of new patients are reported to develop this condition. The mortality rate of these patients ranges from 50–70%, especially in the setting of multiple-organ dysfunction (MODS) or the need for dialysis. The majority of patients do not die from the renal failure directly, but rather from their comorbid conditions.
Can we use haemodialysis to keep patients on CAPD?
Michelle Clemenger and Edwina A Brown
pp 10-12
Achieving adequate dialysis once a patient on continuous ambulatory peritoneal dialysis (CAPD) has lost residual renal function can be difficult. This often leads to conversion to haemodialysis (HD), which is frequently detrimental to the patient’s lifestyle. The ability to remain on peritoneal dialysis has a positive effect on many patients. Augmentation of peritoneal dialysis with once-weekly haemodialysis can help to maintain dialysis adequacy and also allow the patient to remain on the therapy of his/her choice, retain independence and have a good quality of life.
What I tell my patients about microscopic haematuria (‘dipstick haematuria’)
Charlie Tomson
pp 13-16
Haematuria is the presence of red blood cells in the urine. Large numbers of red blood cells turn the urine red: this is called macroscopic haematuria. On the other hand, microscopic haematuria is the term that doctors use when there are small numbers of red blood cells in the urine. Asymptomatic microscopic haematuria (AMH) is the term used when a patient has microscopic haematuria but has no symptoms of the disease, and so was unaware that there was anything wrong with them until they had a urine test.
Clinical governance in the field of renal medicine
Rachel J Middleton and Donal J O'Donoghue
pp 17-20
In 1998 the Department of Health introduced clinical governance into the lexicon of NHS management. The concept of clinical governance was developed from the success of ‘corporate governance’ in business management. It is defined as, ‘A system through which NHS organisations are accountable for continuously improving the quality of their services and safe guarding high standards of care by creating an environment in which excellence in clinical care will flourish’. Central to this initiative is the understanding that everyone in clinical care is responsible for delivering a high quality service.
The dawn of dialysis: reminiscences of a patient
Professor Robin Eady
pp 21-24
In this fascinating interview, Professor Robin Eady describes his early experiences as a renal patient undergoing pioneering haemodialysis treatment in the 1960s.
Pharmacist-run renal medication review clinics
Clare Morlidge
pp 25-26
Pharmacist-run clinics have been identified as a potential benefit to patients. A total of 18% of renal admissions are due to an adverse drug reaction (ADR). In medication review clinics pharmacists are able to tailor drugs to suit the patient, identify unnecessary drugs and hopefully reduce the percentage of ADRs. At the Walsgrave Hospital we thought that compliance would be improved if patients had an opportunity to discuss their drugs in more detail than the usual clinic allows. The importance of ensuring that records are kept up-to-date and that the patient's GP is always appropriately informed was also recognised.

The British Journal of Renal Medicine was previously supported by Baxter Healthcare from 2011 to 2013, by Sandoz in 2011, by Shire Pharmaceuticals from 2006 to 2011, by Ortho Biotech and Shire Pharmaceuticals in 2005, by Ortho Biotech from 2000 to 2005 and by Janssen Cilag from 1996 to 2000.

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